THE NATURE OF OCCUPATIONAL THERAPISTS' CHANGE AGENT ROLE: RESULTS FROM A SCOPING STUDY

Background: In light of healthcare services’ rationalization and an increased focus upon health promotion, acting as a change agent may be a critically important, albeit challenging, role for occupational therapists (OTs)... [ view full abstract ]

Background:
In light of healthcare services’ rationalization and an increased focus upon health promotion, acting as a change agent may be a critically important, albeit challenging, role for occupational therapists (OTs) (1,2). A better understanding of this role is essential (2). The objective of this study was to describe the change agent role of OTs.
Method:
A scoping study (3) of the scientific literature from January 1975 to February 2012 was undertaken. Nine databases, including Medline and CINHAL, were searched with various keywords. Data were examined using thematic charts and analysis (4).
Results:
From the 43 documents analyzed, two change agent configurations were identified: global and clinical. Stemming from personal or organized-group initiative, the global configuration mostly operates at the macro-level (society), usually aimed at optimizing health and social justice for communities or populations. Actions include lobbying, public speeches, using media, promoting research results, collecting funds and assuming a formal duty in an advocacy group. At the micro-level (clinical setting), the clinical configuration’s intent is mainly to inform, sustain and promote individuals’ decision-making and protect their civil rights. Doing so primarily involves discussion with the client to understand his/her values and provide information about rights and options, as well as discussion with colleagues and managers.
Conclusion:
The change agent role entails two configurations, each operating at a different level, according to aims and persons targeted, leading to distinct actions. Better understanding these configurations is important to inform OTs about possible actions to optimize their change agent role.